Insider View: Patients and Doctors

Jul 14, 2009

We are happy to bring you the first of a series of posts provided by people working within a unique field. These “Insider Views” are intended to provide an on-the-ground perspective of a particular field. This post was written by my good friend, and Demetrius’ brother, Octavious Madrigal. His experience in the medical field has given him unique insight into the delivery of medical care, at the point of contact between patients and doctors. We can all benefit from his valuable thoughts and hopefully improve not just our relationship with our doctor, but also our health.

In today’s fast paced life, communication isn’t what is used to be. Text and twitter have replaced letter writing and conversations and people are left out of the loop if they don’t have a Facebook account or check their e-mail 4 to 5 times a day. The question I constantly ponder is what’s considered really important in life and what should be on the forefront of our minds? Is it the meeting with your stock broker? How about text messaging with your boss? Or what about MySpace and Facebook posts to family and friends? I think that the one person that gets put on the back burner who is really important in life is the family doctor. There are very few conversations as important as one that you have with your doctor.

I am a medical assistant and have been one for the past 2 years. While rooming a patient earlier in the year, I chastised the patient for not coming in sooner for an annual exam. After stepping out of the room I caught myself and realized it had been almost a decade since my last exam. I promptly made an appointment that day. I readily admit that it was a bit easier for me than it would be for the average person. I chose the doctor in the office next to me, with whom I already had a relationship. The conversation and exchange of information with the medical assistant could easily have been embarrassing, as she sits at the next desk next to me, but I knew of the professional courtesy that not only exists for us, but for all patients. The Health Insurance Portability and Accountability Act (HIPAA) made it illegal to discuss anyone’s medical records if it’s not directly related to care. It’s also illegal for them to discuss or leave detailed messages with anyone not previously designated. The comfort level I had is because I work in the same clinic, but I honestly believe that everyone should have this level of comfort when visiting a doctor’s office.

Most people only see their doctor if there is something wrong or in the case of the H1N1 virus, become worried about an epidemic. If we want patients to feel more comfortable visiting us, we need to understand what makes them hesitant to visit and fix it.

What the patient can do – communicate your concerns
You can help your doctor with your health care not only by listening but by talking. Most people are embarrassed by one thing or another and ignore it until it’s out of control can lead to extensive treatment. For example, I see people who have what are considered minor abnormalities in lab work, blood pressure or other concerns, toss away what their doctors tell them moments after the conversation. Activities, diet and life styles don’t change and what was once a minor blip in lab work becomes a case that could require much more intensive treatment. Medication is not always a simple form of treatment. Depending on the diagnosis, it could require multiple follow-ups with lab work until the proper dosage is achieved. Something more severe can require referrals to specialists, hospital stays, or surgery. This adds to the high cost of health care which could have been avoided by making the changes your doctor suggested before it got to the point it did. If you are not comfortable bringing up the topic face–to-face with your doctor, try mentioning it to the medical assistant or nurse. If you aren’t comfortable with that either, call and leave a message or e-mail your doctor if that is an option. Open discussion should always take place. If you have an appointment and you have a concern that was not part of the day’s appointment, bring it up as soon as you see the doctor. The doctor may have important issues to discuss, but what you have to say may be related to your complaint or it may even be more important than the other symptoms our experiencing. Don’t let any concerns you have go un-discussed as it may lead to major problems down the road.

What we as healthcare professionals can do – help patients become more open about their concerns
It also falls to those of us in health care to do all we can to create an environment in which open communication flows freely. It’s no secret that a trip to the doctor for whatever reason can be intimidating. A fear of needles alone is enough to shut the mouths of some patients in urgent need. An association with doctors and hospitals with illness and death can cause others to grit their teeth and just hope for a simple office visit to be over as quickly as possible. Some doctors are better at making a patient feel more comfortable than others, but it’s the responsibility of everyone to try to think about the patient’s experience in the office and try to create an atmosphere that makes the patient feel comfortable and able to disclose. Whether it’s through communication, spending a little extra time with patients to learn more about them, using Facebook, Twitter, or simple email to maintain personal contact outside of the office, there are numerous avenues still to be explored, some provided by new technology in the world. As much as it is the responsibility of patients to tell us everything that is happening in their bodies, it is also the responsibility of every healthcare professional to adapt to our patients and do our best to make them feel that they are accepted and able to reveal anything. With any luck patients will do their part and reveal potentially embarrassing concerns or seemingly unimportant nagging pains that can help us to keep them healthy.

Few would argue that health is the most important factor in life. Maintaining good health is not as easy as it sounds with all the external factors and temptations in the world. It can be easier with open, honest communication with your doctor. Listen to what the doctor has to say and follow through with the suggestions. If you have concerns, bring them up and don’t be embarrassed to discuss anything. In the long run, following these simple pieces of advice can help you to feel better, save money and potentially live longer. With benefits like that, who wouldn’t want to talk with their doctor?

Written By: Octavious Madrigal, Medical Assistant